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Ginger and menstrual cramps

by Tori Hudson, ND

Menstrual cramps are one of the most common problems that women face, affecting over 50 percent of menstruating women.  Pain relief of primary dysmenorrhea, or painful menstrual cramps, is often well addressed with some simple botanical therapies.  Ginger is one such plant, that offers practitioners a good option for their patients, and with not only a long history of traditional use, but some recent published research.

A double-blind comparison trial was conducted in 150 reproductive aged college students 18 years and older, with primary dysmenorrheal.  Women were divided into three groups.  Group one received ginger (Zingiber officinale) rhizome powder capsules, 250 mg four times a day for three days starting day one of their menses.  The second group received 250 mg mefenamic acid capsules, four times daily days one through three, and the third group took 400 mg ibuprofen capsules four times daily again, days one through three of the menses. 

At baseline, pain severity and menstrual characteristics were assessed by a self-administered questionnaire with a four grade scoring system:  painless menstruation= 0; menstruation with pain but rare use of analgesics or limitation of activities = 1; moderate pain with menstruation with influence on daily activities and use of analgesics that provide relief= 2; menstruation with severe pain with significant limitations on daily activities and ineffective use of analgesics=3. Women with moderate to severe pain scores of 2 or 3 were included.  In addition to the above scoring system, a 5-point scale was used to assess pain relief(considerable relief, relief, unchanged, worse, considerably worse). Assessment was performed after one menstrual period by a colleague who had no information about the groups.  Patients and colleague assessor were blinded to the groups.   

At the end of treatment, the severity of dysmenorrhea decreased in all groups and no differences were found between the groups in pain severity, pain relief or satisfaction.

More women in the ginger group became completely pain free, vs the mefenamic acid and ibuprofen groups.  The rate of satisfaction from the treatments was 20/50 women in the mefenamic acid group, 22/50 women in the ibuprofen group and 21/50 women in the ginger group.

Commentary

While ginger has been used historically for its anti-inflammatory properties, this is the first study to my knowledge that has been published on ginger and primary dysmenorrheal.  The findings of this study clearly demonstrate that ginger was as effective as mefenamic acid and ibuprofen in the relief of menstrual pain. The cause of menstrual cramps is thought to be due to an increased production of prostaglandins in the endometrium (lining of the uterus). Menstrual blood of women with primary dysmenorrhea have greater amounts of the prospasmodic and proinflammatory prostaglandins, PGE2   and PGF2 alpha Both mefenamic acid and ibuprofen act as inhibitors of the synthesis of these prostaglandins. Ginger also inhibits cyclooxygenase and lipooxygenase pathways in prostaglandin synthesis and the gingerols in ginger have anti-inflammatory effects in vitro and in vivo.  It is this ability of ginger to inhibit cyclooxygenase and lipooxygenase that leads to reduction in leukotriene and prostaglandins, and consequent pain relief.

Ginger has also been found to contain salicylates, although less than 1 mg of salicylate, which would lead one to conclude that the salicylate content would not account for it’s pain relieving effects.   Consider using ginger root either alone, or in combination with other important natural ingredients in the relief of menstrual cramps such as the evidence based niacin and vitamin B6, and the traditional botanicals crampbark, valerian and wild Yam.

References

Study referenced from Ozgoli G, Goli M, Moattar F.  Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea.  J Alternative and Complementary Med 2009; 15(2):129-132.

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